APPLICATION FOR THE POST OF MALE SPORTS PERSON (Fill all columns in legible capital letters & use A4 Size paper)
Asstt General Manager (HRM), United Bank of India, Head Office, United Tower HRM Department, 12th Floor, 11, Hemanta Basu Sarani, Kolkata – 700 001 (W.B.)
PLEASE AFFIX YOUR RECENT PHOTOGRAPH AND SIGN ACROSS
I hereby submit my application for the above post in the prescribed format. (Please indicate by tick) Post Code
01
Sports Person (Officer) Sports Person (Clerk)
Name of the Post
02 INDICATE THE FIELD OF SPORTS IN WHICH YOU LIKE TO APPLY (Please Indicate by √ ) Football 1.
Cricket
Table Tennis
Boxing
Wrestling
Athletics
FULL NAME (IN BLOCK LETTERS) Shri.
2.
_________________________________________________
SEX : (Tick in the appropriate box) :
MALE
FEMALE
3 . (i) ADDRESS FOR CORRESPONDENCE (IN BLOCK LETTERS): ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------(ii) PERMANENT ADDRESS :
-----------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------PIN SINGLE 4.
MARRIED
MARITAL STATUS ;
5.
FATHER’S / HUSBAND’S NAME: (IN BLOCK LETTERS) ________________________________
6.
NATIONALITY: ______________
7.
Date of Birth (As per School leaving Certificate SSLC) Date_______ Month_____ Year________. Age as on 01.08.2012 ____Years____ Months.
8.
Indicate the Category in which you belong by Ticking the appropriate box
Page 1 United Bank of India, Head Office, Unite Tower, 11, Hemanta Basu Sarani, Kolkata-700001.
SC ST OBC GENERAL (Please attach attested copy of Certificate wherever necessary) 9. CONTACT DETAILS TELEPHONE NO. (with STD code) : E-MAIL_ID ______________________ MOBILE NO.:__________________________
10.
Details of Application fee. Name of the Bank & Branch where paid
Branch SOL Id
Transaction ID
Deposit Date
Amount
11. Please specify •
YES Are you a candidate who had ordinarily been domiciled in Kashmir Division of the State of J&K during the period of 01.01.1980 to 31.12.1989?
•
Are you an ex-serviceman?
•
Do you belong to Minority community? (Tick in the appropriate box) If yes, please state the community:
______________
In case of SC/ST/OBC Candidate, name of the Caste/Tribe/Class
____________
•
YES
YES
NO NO
NO
12. Educational and Professional Qualifications (as on 01.08.2012): (a ) Details of Education (10th standard onwards) (copies of certificates t to be attached) Examination passed
Name of the Institution/University
Subjects studied in detail
Date, Month, year of passing
Percentage of aggregate marks
Class / Division
(If space is not sufficient please, attach separate paper)
(b) )
Details of Sports Qualification as per the eligibility criteria prescribed
Page 2 United Bank of India, Head Office, Unite Tower, 11, Hemanta Basu Sarani, Kolkata-700001.
for the posts concerned in the advertisement .(attested copies to be attached) . Name of the Field of Sports
Represented at the National /State/District/ University /Combined Universities level
Details of Distinction achieved
Details of Prizes /Medals Won
Authority awarding Certificate/Medals etc
(If space is not sufficient please, attach separate paper)
13. Particulars of Post Qualification Experience (if any ) including the Present Occupation / Job (As on 01.08.2012: Name of the employer (s) / firm etc. and the nature and details of activities carried out by the employer
Designation and rank, if any
Period of Service
From
Length of Service Yrs. Months/ days
To
Nature of Games/Athelitics performed in detail
Remarks (Reasons for leaving services)
14. Languages known: Sl.No.
Language
Read*
Write*
Speak*
*(Mark ‘X’ in the appropriate box) BEFORE DESPATCH OF APPLICATION PLEASE CHECK THAT YOU HAVE CORRECTLY FILLED UP All THE DETAILS AS MENTIONED IN THE ADVERTISEMENT and attached copy of the following documents.
a) b) c) d)
Deposit Challan Certificates for SC / ST/ OBC for claiming relaxation in age and application fees Secondary School Certificate / School leaving certificate or any documentary proof of age. Mark Sheet (Year wise) showing specifically the subject studied and certificates in respect of educational qualification viz SSLC, HSC, and Graduate Degree. e) Relevant certificates in support of Sport Qualification .
DECLARATION: I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that if any information is found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements of the relative advertisement, my candidature / appointment is liable to be cancelled / terminated. I am willing to serve any where in India. I agree that Bank has the right to transfer me to any part of the country at its discretion. I hereby agree that any legal proceedings in respect of any matter (s) or claims or disputes arising out of this application and / or out of said advertisement can be instituted by me only at Kolkata and Courts / Tribunals / Forums at Kolkata only shall have sole and exclusive jurisdiction to try the cause / dispute. I undertake to abide by all the terms & conditions mentioned in the advertisement given by the Bank.
PLACE:
Page 3 United Bank of India, Head Office, Unite Tower, 11, Hemanta Basu Sarani, Kolkata-700001.
DATE:
SIGNATURE OF CANDIDATE
Page 4 United Bank of India, Head Office, Unite Tower, 11, Hemanta Basu Sarani, Kolkata-700001.
